Clinical outcomes of patients with coronary artery aneurysm after the first generation drug-eluting stent implantation

Hyung Joon Joo, Cheol Woong Yu, Rakkyeong Choi, Jinsik Park, Hyun Jong Lee, Je Sang Kim, Young Jin Choi, Jae Hyoung Park, Soon Jun Hong, Do-Sun Lim

Research output: Contribution to journalArticle

Abstract

Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32%), fusiform (13%), or microform (55%). The stent types involved were Cypher (n=56, 71.8%) and Taxus (n=22, 28.2%). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2%, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0%, P<0.001) and TLR (20.5 vs. 1.9%, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74%, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - 2017 Jan 1

Fingerprint

Coronary Aneurysm
Drug-Eluting Stents
Coronary Vessels
Myocardial Infarction
Stents
Incidence
Microfilming
Taxus
Propensity Score
Cause of Death
Thrombosis

Keywords

  • Coronary artery aneurysm
  • Drug-eluting stent
  • Major adverse cardiac event
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Clinical outcomes of patients with coronary artery aneurysm after the first generation drug-eluting stent implantation. / Joo, Hyung Joon; Yu, Cheol Woong; Choi, Rakkyeong; Park, Jinsik; Lee, Hyun Jong; Kim, Je Sang; Choi, Young Jin; Park, Jae Hyoung; Hong, Soon Jun; Lim, Do-Sun.

In: Catheterization and Cardiovascular Interventions, 01.01.2017.

Research output: Contribution to journalArticle

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abstract = "Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32{\%}), fusiform (13{\%}), or microform (55{\%}). The stent types involved were Cypher (n=56, 71.8{\%}) and Taxus (n=22, 28.2{\%}). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2{\%}, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0{\%}, P<0.001) and TLR (20.5 vs. 1.9{\%}, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74{\%}, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.",
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AU - Joo, Hyung Joon

AU - Yu, Cheol Woong

AU - Choi, Rakkyeong

AU - Park, Jinsik

AU - Lee, Hyun Jong

AU - Kim, Je Sang

AU - Choi, Young Jin

AU - Park, Jae Hyoung

AU - Hong, Soon Jun

AU - Lim, Do-Sun

PY - 2017/1/1

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N2 - Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32%), fusiform (13%), or microform (55%). The stent types involved were Cypher (n=56, 71.8%) and Taxus (n=22, 28.2%). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2%, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0%, P<0.001) and TLR (20.5 vs. 1.9%, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74%, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.

AB - Objectives: We sought to investigate the long-term clinical outcomes of patients with coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation, compared with patients without CAA. Background: CAA developed after DES implantation is a rare but associated with poor clinical outcome. Methods: We retrospectively compared 78 patients with CAA after DES implantation with 269 patients without CAA who underwent DES implantation for complex lesions (controls). The primary endpoint was defined as major adverse cardiac events (MACE), the composite of all-cause death, nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Results: Morphologically, CAAs were saccular (32%), fusiform (13%), or microform (55%). The stent types involved were Cypher (n=56, 71.8%) and Taxus (n=22, 28.2%). During a median follow-up period of 1164 days, the incidence of MACE was significantly higher in the CAA group (26.9 vs. 2.2%, P<0.001); the difference was driven mainly by nonfatal MI (11.5 vs. 0%, P<0.001) and TLR (20.5 vs. 1.9%, P<0.001). The incidence of stent thrombosis was higher in the CAA group (12.8 vs. 0.74%, P<0.001), irrespective of the maintenance of dual antiplatelet therapy. In the CAA group, Cox regression analysis showed significantly higher hazard ratios of CAA for MACE during the follow-up period. Further analyses after propensity-score matching of 65 pairs also showed similar results. Conclusions: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.

KW - Coronary artery aneurysm

KW - Drug-eluting stent

KW - Major adverse cardiac event

KW - Percutaneous coronary intervention

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